Tracheostomy versus mandibular distraction osteogenesis in infants with Robin sequence: a comparative cost analysis

Area of Science:

• Craniofacial Surgery
• Pediatric Otolaryngology
• Health Economics

Background:

• Robin sequence often presents with severe respiratory distress in infants.
• Established treatments include mandibular distraction osteogenesis and tracheostomy.
• Comparative cost-effectiveness and complication data are limited.

Purpose of the Study:

• To compare the costs and complications of mandibular distraction osteogenesis versus tracheostomy in infants with isolated Robin sequence.
• To inform optimal treatment strategies and institutional protocols.

Main Methods:

• Retrospective analysis of nine infants with isolated Robin sequence.
• Five infants underwent mandibular distraction osteogenesis, and four underwent tracheostomy.
• Data on direct (hospitalization, diagnostics, surgery, homecare) and indirect (parental absence from work) costs and complications were collected over 12 months.

Main Results:

• Tracheostomy incurred costs three times higher than mandibular distraction osteogenesis (€105,523 vs €33,482).
• Indirect costs for tracheostomy were nearly five times higher (€2,543 vs €543).
• Overall total costs were threefold higher for tracheostomy, with four times more complications.

Conclusions:

• Mandibular distraction osteogenesis is significantly less expensive and results in fewer complications than tracheostomy for infants with Robin sequence.
• These findings support mandibular distraction osteogenesis as a preferred intervention, potentially guiding future clinical protocols.